Provider Demographics
NPI:1255398152
Name:CAMPBELL, VIRGINIA A (DO)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DO
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:6511 JOHNSON DR
Practice Address - Street 2:MISSION FAMILY HEALTH CARE
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2616
Practice Address - Country:US
Practice Address - Phone:913-945-9680
Practice Address - Fax:913-945-9681
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2014-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS05-19488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
25562039OtherBCBS KUMW UC
10448055OtherBCBS
481159444OtherJAYHAWK TAX ID
10001636000OtherCHP PROVIDER NUMBER
325323OtherFIRSTGUARD KUMW UC
2061912OtherAETNA
2981830OtherAETNA KUMW UC
KS100428200AMedicaid
157695XXOtherPREFERRED CARE OF NY
481159444OtherJAYHAWK TAX ID
25562039OtherBCBS KUMW UC
E47009Medicare UPIN